{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:59:27Z","timestamp":1785329967178,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010398","name":"Metro South Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010398","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microcirculation"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study investigated the relationship between sublingual microcirculatory tortuosity, frailty index scores, and endothelial glycocalyx blood biomarkers in individuals with chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sublingual microcirculatory videos were analyzed using a 0\u20134 tortuosity scoring scale. Plasma concentrations of syndecan\u20101 and soluble thrombomodulin were quantified using enzyme\u2010linked immunosorbent assay (ELISA). Frailty status was assessed using a short\u2010form frailty index questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 44 patients (median age 53\u2009years, IQR 45\u201364) attending a kidney transplant assessment clinic, with equal representation of males and females. The median frailty index was 0.19 (IQR: 0.15\u20130.30), with 63.5% of participants having an FI score &lt;\u20090.25. Intraclass correlation coefficient (ICC) analysis demonstrated excellent inter\u2010observer reliability for tortuosity scoring. Frailty index scores were significantly higher in participants with tortuosity scores of 3\/4 compared to those with a score of 0. No significant differences were observed in syndecan\u20101 or soluble thrombomodulin levels across tortuosity scores. Ordinal logistic regression identified frailty index score as the only significant predictor of tortuosity, independent of age, dialysis type, or sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher frailty index scores were associated with increased sublingual microcirculatory capillary tortuosity, though this relationship did not extend to endothelial glycocalyx biomarkers. These findings highlight the potential value of incorporating tortuosity assessment alongside density and perfusion measures in microcirculatory evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/micc.70072","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:32:21Z","timestamp":1780558341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship Between Sublingual Microcirculatory Structure and Frailty in Renal Transplant Candidates: Exploring Tortuosity &amp; Endothelial Glycocalyx Biomarkers"],"prefix":"10.1111","volume":"33","author":[{"given":"Ryan A. P.","family":"Homes","sequence":"first","affiliation":[{"name":"School of Biomedical Sciences, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trent","family":"Payne","sequence":"additional","affiliation":[{"name":"Australian Frailty Network The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Giddens","sequence":"additional","affiliation":[{"name":"Department of General and Geriatric Medicine Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross S.","family":"Francis","sequence":"additional","affiliation":[{"name":"Department of Nephrology Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth E.","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Australian Frailty Network The University of Queensland  Brisbane Australia"},{"name":"Department of General and Geriatric Medicine Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily H.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Australian Frailty Network The University of Queensland  Brisbane Australia"},{"name":"Department of General and Geriatric Medicine Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Midwinter","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"},{"name":"Traumatic Injury Sciences Group The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Stevens & Lowe's Human Histology","author":"Lowe J. S.","year":"2015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.115.305364"},{"key":"e_1_2_11_4_1","first-page":"1","article-title":"Normal Endothelium","volume":"176","author":"Pries A. R.","year":"2006","journal-title":"Handbook of Experimental Pharmacology"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/10739689509146755"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2019.11.003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12340"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.13216"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12784"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/micc.12448"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-01922"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2020.679"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5070-7"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc6118"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2013.06.015"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1492-1"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201308-277OC"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40942-025-00688-z"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1479164112446302"},{"issue":"3","key":"e_1_2_11_20_1","article-title":"Characterization of Sublingual Microvascular Tortuosity in Steady\u2010State Physiology and Septic Shock","volume":"13","author":"Chalkias A.","year":"2025","journal-title":"Biomedicine"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00521-014-1657-2"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.311378"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1907-7"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44161-022-00045-5"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/micc.12819"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.00172"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05700-w"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/aft160"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13944"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-013-9758-y"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcad173"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12231"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000522394"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003275"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2014.03.016"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2022.04.006"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12182"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-021-02671-3"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0400-x"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/62.7.738"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318210385c"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001695"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2011121181"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfad051"}],"container-title":["Microcirculation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/micc.70072","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/micc.70072","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/micc.70072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:03:57Z","timestamp":1785326637000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/micc.70072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/micc.70072"],"URL":"https:\/\/doi.org\/10.1111\/micc.70072","archive":["Portico"],"relation":{},"ISSN":["1073-9688","1549-8719"],"issn-type":[{"value":"1073-9688","type":"print"},{"value":"1549-8719","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"assertion":[{"value":"2026-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70072"}}